External Version: Second Try to Turn Breech Baby?

After three weeks of exercise designed to get my baby to turn, it is still breech and in a sunny-side-up position at 37 weeks. My doctor attempted an external version and the pain was more than I could handle. Is it worth another try, using terbutaline and an epidural, or should I plan to have a cesarean when labor starts?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I understand your hesitation and I know that external version can be quite uncomfortable. But looking at the statistics demonstrates that the benefits outweigh the risks for this procedure. If the baby is posterior, this correlates with a lower chance of success in turning the baby.

I have never heard of doing a version with an epidural. This would increase the risk of fetal complications a bit. This procedure is always done with continual monitoring of the fetal heart and most often with the assistance of ultrasound.

Success rates for version run about 65 percent in the U.S. studies. The average cesarean delivery rate is 37 percent among those undergoing an attempted version compared with 83 percent among the control groups.

I have seen a number of versions and it has always impressed me that mothers respond so differently. I always admired the physicians who heeded the mother's signs that she could not tolerate it. When versions are difficult, it is best not to push it.

Your decision is based on so many variables, that it is difficult to advise you. Beside your baby's position, one must consider how you would respond to the terbutaline, the baby's size and weight, the amount of fluid, the position of the cord and placenta, etc.

I think another attempt at version is reasonable. Cesarean section can have significant risks for you and for your baby.

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